A 26-Year-Old Previously Healthy Man Comes to the Emergency Department

A 26-year-old previously healthy man comes to the emergency department due to fever, malaise, anorexia, and painless swelling of the left eye.  His symptoms began after a month-long anthropology trip to rural Bolivia.  During his stay, he lived in an adobe house with a thatched roof and unnetted windows and doors.  Temperature is 38.3 C (101 F) .  Physical examination shows left-sided periorbital swelling and conjunctival erythema with no discharge.  The remainder of the physical examination, including right eye examination, shows no abnormalities.  Giemsa-stained peripheral blood smear is shown below:   This patient is at greatest risk for which of the following complications if his condition is left untreated?

A) Ascending aortic aneurysm
B) Calcified brain lesions
C) Cardiac arrhythmias
D) Large joint arthritis
E) Periportal liver fibrosis

Correct Answer:

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